Dystrophic calciphylaxis in panniculitis: features of the clinical picture and diagnosis

The clinical presentation of lobular panniculitis (PN) associated with calciphylaxis (CP, calcification) can vary widely and may be joint internal organs involvement, making the diagnosis disease difficult. Objective : to evaluate frequency significance CP in patients PN using long-term prospective follow-up. Material methods . From 2018 2023, at V.A. Nasonova Research Institute Rheumatology 217 referral "erythema nodosum" or "panniculitis" were examined. In 19.3% cases (9 men 33 women aged 37 72 years) was confirmed an average duration 56.3±11.2 months. Clinical examination performed according standards recommended by Russian Association Rheumatologists. International criteria used confirm systemic lupus erythematosus (SLE), idiopathic inflammatory myopathies (IIM), sclerosis (SS), lipodermatosclerosis (LDS). 12 indurations, pathological biopsy specimens skin subcutaneous fatty tissue from area induration performed, which allowed confirming (ILPN) 3 cases. Four grades calcification distinguished size depth calcifications. addition, considering type radiological changes manifestations, four subtypes identified: mousse-like, stone-like, mesh-like lamellar-like. Results discussion study group, ratio 3.6:1, mean age 43.8±7.6 years. On we determined, 60% predominantly stone-like subtype (71.4%) first grade (47.6%), significantly more frequently located on upper and/or lower extremities trunk (57.1%; p=0.05). Using clinical, laboratory instrumental data, development ILPN (n=3), SLE LDS (n=21), IIM (n=5), SS (n=1), (n=9) a 8.7±2.4 An increase ESR CRP levels occurred different diseases, while urinary syndrome (66.6%) creatinine phosphokinase IIM. Decreased calcium 25-hydroxyvitamin D increased phosphorus parathyroid hormone found many studied. Conclusion absence clear diagnostic for PN, early is critical effective multidisciplinary treatment plan.